Radiation therapy for testicular cancer

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is sometimes used to treat testicular cancer. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.

Radiation therapy is given for different reasons. You may have radiation therapy to:

• destroy the cancer cells in the body
• destroy cancer cells left behind after surgery or chemotherapy to reduce the risk that the cancer will come back (recur) (called adjuvant therapy)

During external radiation therapy (also called external beam radiation therapy), a machine directs radiation through the skin to the tumour and some of the tissue around it.

Radiation therapy works best for seminomas. Non-seminomas do not respond well to radiation therapy. Doctors are more likely to offer radiation therapy if there is a higher risk of the cancer coming back, such as when the primary tumour is large or cancer has spread to the back of the abdomen (retroperitoneum).

External radiation therapy may be used for stage 1 and stage 2 seminomas after surgery to remove the testicle (called a radical inguinal orchiectomy, or an orchiectomy). Radiation is directed at the lymph nodes in the back of the abdomen. Sometimes it is also directed at the lymph nodes in the pelvis. The healthy testicle is protected from the radiation by a shield.

Side effects can happen with any type of treatment for testicular cancer, but everyone’s experience is different. Some men have many side effects. Others have few or none at all. Your radiation oncologist will discuss possible side effects in great detail with you.

During radiation therapy, the healthcare team protects healthy cells in the treatment area as much as possible. But damage to healthy cells can happen and may cause side effects. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after radiation therapy. Sometimes late side effects develop months or years after radiation therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation and the treatment schedule. Some common side effects of radiation therapy used for testicular cancer are:

• fatigue
• nausea and vomiting
• diarrhea
• stomach ulcers
• skin problems
• fertility problems
• sexual problems for men, including erectile dysfunction
• low blood cell counts
• heart damage
• second cancers

Tell your healthcare team if you have these side effects or others you think might be from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Find out more about radiation therapy and side effects of radiation therapy. To make the decisions that are right for you, ask your healthcare team questions about radiation therapy.